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22 PROVINCIAL MEDICAL SOCIETIES. Dr. WIGHTWICIK maintained that all post-mortem examina- tions should be made by special pathologists. Dr. SYKES was inclined to attribute most cases occurring among the poor to the neglect of disinfection of bedding after infectious diseases, especially typhoid fever. Dr. WILLOUGHBY, while strongly insisting on the septic origin of all puerperal fever, which he would have called by its proper name of puerperal septicaemia, agreed with Dr. Sykes as to the necessity for disinfection. On the motion of Dr. GIBBON, seconded by Dr. WOODFORD, it was resolved that the Society should confer with the Obstetrical Society on the extension of instruction in midwifery. Dr. GARRETT then read a paper on the ° Spontaneous Pollu- tion of Water originally Pure in Storage Reservoirs." The water-supply of Cheltenham was, he said, drawn from two sources : the river Chelt, and from openings in the oolite of the Cotteswold hills. The latter was moderately hard (12°- 16°), but of extraordinary purity, yielding only 0 -04 per million of albuminoid ammonia and absorbing no more oxygen than ordinary distilled water. One of the reservoirs was covered, the other two were open. Complaints having been made that the town water had a " fishy taste" suspicion fell on the Chelt as the less pure, but it was soon ascertained that the fault lay with the open reservoirs on Hewlett’s Hill and that the cause was the growth of Chara, which was not found in the covered reservoir, since like all plants forming chlorophyll it needed light. Dr. Garrett exhibited specimens of the Chara. It grew luxuriantly in the early summer, but in autumn broke up to a great extent, rendering the water turbid with its disintegrated and decom- posing tissues, which swarmed with organisms of every kind and emitted odours, fascal and other. Dr. Farrow of Harvard had referred these odours to Lynglya Beggiatoa and Nostoe respectively, and Dr. Adams of Bolton ascribed the stale-fish smell to Converva Bombycina ; but this last was not found at Cheltenham, where the Lynglya abounded. The Chara softened the water remarkably. Peaty waters containing vegetable matter were acid, but this was slightly alkaline. Attempts to exterminate the plant were un- successful, and Dr. Garrett had advised the use of the covered reservoir only, and that when it was necessary to have recourse to the others, that the water should not be allowed to remain in them any length of time.-Drs. Bostock Hill, Thresh, Willoughby and others took part in the discussion. PROVINCIAL MEDICAL SOCIETIES. BRADFORD MEDICO-CHIRURGICAL SOCIETY.-A clinical meeting was held on Dec. 20th, 1892, Dr. Bell, President, in the chair. Dr. S. LODGE showed a young woman aged twenty-four suffering from Chronic œsophagitis. For four years she had suffered pain on swallowing solids. The tenderest part appeared to be on a level with the lower third of the sternum. There was an excessive appetite and pyrosis, but no other evidence of disease. She was relieved by restriction to liquids and the exhibition occasionally of a little bismuth. Dr. Lodge also brought forward a case in which a mastoid operation was performed. There had been epistaxis with signs of meningitis, including fever, slow pulse and double optic neuritis. The mastoid cells being opened the patient steadily improved and the neuritis and other signs dis- appeared. In another case shown with Facial Palsy Dr. Lodge had opened the mastoid, scraped out some dead bone and the paralysis disappeared.-Dr. MAJOR showed a patient probably affected by lead. The lower branches of the facial nerve were paralysed, whilst the upper were free. The paralysed palate responded readily to direct stimu- lation. Dr. Major also showed two patients, both suffering from early General Paralysis. There was no syphilitic history obtainable and neither had grandiose delusions. He strongly advocated surgical treatment of all cases with much headache, as improvement was to be expected.-Dr. BELL showed a case of Primary Shrinking of the Conjunctival Sac until the eye was closed in and the eyeball immovably fixed between the closed and adherent lids ; he had shown a similar case to the Society sixteen years ago. A few others had been reported since, especially in connexion with pemphigus, but in neither of his cases had there been this association. A case of Primary Calcareous Degeneration of the Cornea was also shown by Dr. Bell; a few such had lately been reported. It began on the upper part of the cornea, just under the surface, which was smooth and covered by a layer of epithelium ; there was neither pain nor ulceration. The area of the pupil was nearly covered. This case was unique in that absorption of the calcareous matter was progressing in the parts covered by the lids.-Dr. ArPLEyARD showed Seven Elbows in which he had practised excision with varying results. In one case "reflex " paralysis had ensued with loss of the use of the deltoid and muscles passing over the elbow, except those attached to the inner condyle. There was no loss of sensation. Other cases of interest were also shown at this meeting. MANCHESTER CLINICAL SOCIETY.-At a meeting held on Dec. 20th, 1892, Dr. T. C. Railton, M.D., M.R.C.P., occupied the chair.-Dr. MILLIGAN showed several patients suffering from the presence of Naso-pharyngeal Adenoids. A short historical sketch of the disease was given. The histological characters of adenoid tissue were discussed and microscopic specimens shown. It was pointed out that the disease should be considered as the local manifestation of a dyscrasia closely akin to scrofula and that it was responsible for at least 50 per cent. of the nasal catarrhs of childhood. The symptomatology of the affeotion was briefly touched upon, special mention being made of secondary affections of the ear. Great stress was laid upon the importance of early and radical surgical interference, especially in those children who at the same time suffered from recurrent attacks of deafness and earache. It was pointed out that even although the growths did show a marked tendency to atrophy during adolescence the surgeon was not justified in waiting for this atrophic change to take place, seeing that during the period of retrogression serious and irreparable changes might happen to the organ of hearing. The various methods of removing the growths were then discussed and the requisite instruments shown.- Dr. STEELL related two cases of Aortic Incompetence illus- trative of the prognosis of the disease. The first case was that of a man aged thirty-two who was free from syphilis or gout and had not suffered from rheumatism or chorea, but had been exposed to making great physical efforts. The patient suffered during the last few months of his life from angina pectoris and dyspnoea, but had not de- veloped dropsy or engorged liver. He was able to con- tinue his occupation till the day of his death, which re- sulted from subacute heart failure. At the necropsy the aortic valves were found thickened and shrunken and the aorta sound except in the immediate neighbourhood of the _ valves. The orifices of the coronary arteries were implicated and much contracted. The second case was that of a large, powerfully built young man who had had rheu- matic fever when a lad. Physical examination revealed a great amount of aortic incompetence. The patient was for years under observation, suffering occasionally from the symptoms of dyspnoea, dropsy and engorged liver, but of no great severity. These symptoms were always readily removed by treatment and he resumed his work. During the last few years of life his health had improved and he remained free from dropsy and was able to do his work without interruption. Unfortunately he contracted enteric fever, of which he died. At the post-mortem examination the great reactive capacity of his heart in the presence of a grave lesion was explained by the coronary arteries not being involved in disease and by one of them being of unusually large size. A third case was mentioned. It was that of a woman who died of angina pectoris. The aorta was dilated, the valves in- competent and the orifices of the coronary arteries much contracted. Specimens from the three cases were shown.- Dr. ERNEST S. REYNOLDS showed a case of Chronic Hysteria in a female aged twenty-nine years. The attack had come on suddenly when she was fourteen years old, and she had practically remained in the same condition ever since. She showed very marked hysterical mutism and spasm of the right half of the tongue and of the left arm and leg. He also related a case of Landry’s Paralysis, the patient having recently died. She was admitted to the hospital suffering from bronchitis and in a few days she lost the power of standing. The legs then became completely paralysed and also the large muscles of the arms. The toes and fingers could be moved almost to the last. On the eleventh day the respiratory muscles were attacked and she died on the twelfth day of the disease. NOTTINGHAM MEDICO-CHIRURGICAL SOCIETY.-On Dec. 21st, 1893, Mr. R. C. Chicken, F.R.C.S., presided at a meeting of this Society. Mr. GRAY, F.R.C.S., showed a. woman aged sixty-three with an enormous Cystic Enlargement of the Left Breast, probably sarcomatous.-Dr. HEELIS
